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policy

We urge Congress to protect access to care in underserved communities and support the safety net by rejecting site-neutral policies.

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Essential Insights

Leaders at UHealth have shaped local and statewide care services through their community paramedicine training program and say it's the future of American health care.

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policy

The commission's June report to Congress includes illustrative policies about defining and supporting Medicare safety net providers and aligning payments across outpatient settings, among other topics of interest to essential hospitals.

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America's Essential Hospitals expresses its disappointment with the administration's decisions to stand by a bad policy on Part B drug payments and to continue damaging cuts to outpatient care.

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policy

The Centers for Medicare & Medicaid Services will begin reprocessing outpatient claims to excepted off-campus provider-based departments at the lower site neutral payment rate it established in the calendar year 2019 Outpatient Prospective Payment System final rule.

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policy

The Medicare Outpatient Prospective Payment System final rule for calendar year 2021 continues cuts to hospitals in the 340B Drug Pricing Program and off-campus provider-based departments, and updates the overall hospital star ratings methodology.

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The U.S. Court of Appeals decision allows the Centers for Medicare & Medicaid Services to maintain its policy of deep cuts to payments for outpatient care, which will widen gaps in health care access in communities across the country.

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policy

A new proposed rule would extend the Comprehensive Care for Joint Replacement (CJR) model by three years and add outpatient knee and hip replacement to the definition of a CJR episode. Comments are due to CMS by April 24.

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policy

Health care providers have until Dec. 3 to download their preview reports, which include overall hospital quality star ratings.

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policy

The president's fiscal year 2020 budget plan calls on Congress to significantly reform the two programs, including ending Medicaid expansion and changing Medicare uncompensated care payments.

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policy

The rule includes additional cuts to new off-campus, provider-based departments (PBDs), as well as physician payment and quality program changes.

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The final rule's cuts to Medicare Part B drug payments to 340B hospitals jeopardizes health care access for millions of low-income individuals and families nationwide and weakens the ability of essential hospitals to provide vital services to communities.

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policy

The Medicare Physician Fee Schedule proposed rule for calendar year 2018 includes physician payment and quality program changes.

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policy

The FAQs outline how hospitals should complete the form's free-text field and clarify that the form must be issued to Medicare Advantage enrollees.

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policy

Hospitals will be required to provide the form and accompanying instructions to applicable Medicare patients starting March 8.

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policy

The new guidance outlines how and when hospitals must deliver the notice, retention requirements, and how the notices intersect with state laws.

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policy

New guidance describes how off-campus hospital provider-based departments can maintain their grandfathered status when relocating due to extraordinary circumstances.

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Essential Insights

The new 227,420-square-foot clinic will build on the former CEO's vision of ensuring health care for the most vulnerable among us.

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policy

All hospitals and critical access hospitals will be required to provide the MOON to applicable patients beginning March 8, 2017.

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policy

Congress plans to vote on a continuing resolution to keep the government running past Dec. 9. The Senate is expected to pass 21st Century Cures legislation.

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webinar

In this webinar we looked back at the 2016 advocacy landscape, discussed the progress we have made on key issues affecting essential hospitals, reviewed our interaction with the Trump transition team, and looked forward to 2017. Webinar Recording

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policy

Under the rule, CMS would increase the OPPS payment rate by 1.65 percent and provide flexibility in the meaningful use of EHRs, among other things.

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policy

CMS provides more flexibility than previously proposed, ensuring non-grandfathered, off-campus hospital outpatient departments will be reimbursed in 2017.

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policy

America's Essential Hospitals denounces the Centers for Medicare & Medicaid Services decision to limit flexibility and withhold hospital payments for new, off-campus hospital outpatient departments.

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Centers for Medicare & Medicaid Services' narrow interpretation of Section 603 of the Bipartisan Budget Act of 2015 threatens to reduce access to badly needed health care services in the nation's most underserved communities.

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Association supports bill, which would add needed risk adjustment to the Medicare Hospital Readmissions Reduction Program and provide some relief for recent cuts to off-campus hospital outpatient department payments.

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policy

In letter to CMS, association raises issues of payment, definition of off-campus outpatient department of a provider, and 340B eligibility.

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policy

Association responds to House lawmakers' request for comment on Medicare's new payment policy for off-campus hospital outpatient departments. Congress works on FY 2017 budget, holds hearings on Zika virus and opiod abuse.

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policy

The new FAQ clarify that site neutral law won't impact PO modifier requirements. PO modifiers must be included on claims as of Jan. 1 for all services and items furnished in off-campus, provider-based departments.

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quality

Now-voluntary OAS CAHPS will measure patient experience of care in Medicare-certified hospital outpatient departments and ASCs. The first public reporting of data is not expected until 2018.

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policy

House and Senate lawmakers negotiate omnibus appropriations bill and two-year extension of tax cuts, but fail to provide relief on new Medicare site-neutral payment policy for hospital outpatient departments.

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webinar

Participants learned about HRSA's guidance on the 340B Drug Pricing Program and how it will affect their hospital.

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policy

NOTICE Act seeks to educate patients about impact of observation status, including on cost-sharing and skilled nursing facility eligibility.

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policy

Annual release includes 2013 data related to the 100 most common diagnoses for Medicare patients requiring inpatient stays and 30 selected outpatient procedures.

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policy

Preliminary testing to include random, representative sample of 50 hospital outpatient departments, 50 ambulatory surgery centers

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policy

Topics of member interest include payment updates, the OQR Program, and the MSSP.

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policy

The rules, released Oct. 31, finalized a number of provisions regarding payments, data collection in outpatient departments, quality programs, and the MSSP.

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policy

The association urged CMS to revise its C-APC proposal and opposed its proposal to add a claims-based modifier for every outpatient service provided in off-campus provider-based departments.

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quality

Hennepin County Medical Center's Aquí Para Ti/Here for You outpatient clinic provides aims to reduce health disparities for Latino teens using an integrated, bilingual, culturally competent approach to comprehensive youth development and primary health care

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policy

The agency proposes to increase payment rates by an outpatient department fee schedule increase factor of 2.1 percent for CY 2015. CMS also proposes to collect data on services provided in off-campus provider-based departments by requiring hospitals and physicians to identify these services using a modifier on hospital and physician claims.

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policy

CMS released the rule July 3. The agency proposes to increase payment rates by an outpatient department fee schedule increase factor of 2.1 percent for CY 2015. In addition, CMS proposes to collect data on services provided in off-campus provider-based departments by requiring hospitals and physicians to identify these services using a modifier on hospital and physician claims.

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policy

The Ways and Means Committee reviewed hospital issues as part of the Medicare Program. Two Louisiana delegates urged CMS to accept nonprofit-provided premium assistance. The Senate Veterans Affairs Committee held a hearing featuring Secretary Shinseki.

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policy

The measure, OP-31/ASC-11, is part of the ASC Quality Reporting Program and the OQR Program. Data collection, which was scheduled to begin April 1, will now begin Jan. 1, 2015. America's Essential Hospitals successfully encouraged CMS to delay the measure, arguing the measure was not properly tested for the ASC and outpatient settings.

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policy

CMS seeks input on models for specific procedures and complex care. These new payment and service delivery models would apply to specialty practitioner services provided in an outpatient setting.

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policy

Inpatient population and sampling data for chart-abstracted quality measures for the third quarter of 2013 (discharges from July 1 through Sept. 30, 2013) will be due Feb. 8 for the IQR Program. Outpatient population and sampling data and outpatient chart-abstracted measures will be due Feb. 8 for the OQR Program.

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policy

The rule replaces outpatient visit codes with a single code describing all clinic visits

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policy

Rule finalizes several Outpatient Prospective Payment System provisions

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policy

Cuts to evaluation and management payments would disproportionately hurt safety net hospitals

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policy

Clarifies the Outpatient Clinic and Hospital Facility Services definition, Upper Payment Limit.

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policy

The final rule was delayed due to the partial government shutdown

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policy

Agency seeks to understand type and frequency of, and payment for, services furnished in off-campus outpatient departments

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